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阴道分娩女性因会阴切开术导致腹膜后血肿扩展至肾前间隙的保守治疗:一例报告

Conservative Management of Retroperitoneal Hematoma Expanded to Prerenal Space Due to Episiotomy in a Woman with Vaginal Delivery, a case report.

作者信息

Haddadi Mohammad, Hantoushzadeh Sedigheh, Pesikhani Maryam Deldar, Asadi Fatemeh, Amini Sima, Ghaemi Marjan

机构信息

Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Surg Case Rep. 2024 Feb;115:109318. doi: 10.1016/j.ijscr.2024.109318. Epub 2024 Jan 27.

Abstract

INTRODUCTION

Episiotomy is a procedure during vaginal delivery to facilitate a safer delivery. However, it can also have complications including hemorrhage, perineal tears, infections, and vaginal hematoma which should be managed and monitored carefully.

PRESENTATION OF CASE

A 27-year-old woman with term pregnancy, had a normal vaginal delivery at 39 weeks of gestation, and a large episiotomy was performed due to the estimated neonate weight to prevent shoulder dystocia. She was complicated with a huge pelvic hematoma that was expanded to prerenal space.

DISCUSSION

This complication was managed by conservative therapy, including antibiotic therapy, intensive observation of the patient's situation, and follow-up with a CT scan after consulting with a radiologist. The huge hematoma was reduced.

CONCLUSION

Noninvasive management and close monitoring for pelvic hematoma due to episiotomy in a low-risk patient are successful; however, consulting with radiologists and experts and a multidisciplinary approach should be considered.

摘要

引言

会阴切开术是阴道分娩过程中用于促进更安全分娩的一种手术。然而,它也可能引发包括出血、会阴撕裂、感染和阴道血肿等并发症,对此应进行仔细的处理和监测。

病例介绍

一名27岁足月妊娠女性,在妊娠39周时进行了正常阴道分娩,由于预估新生儿体重为预防肩难产而实施了较大的会阴切开术。她并发了巨大盆腔血肿,该血肿扩展至肾前间隙。

讨论

此并发症通过保守治疗进行处理,包括抗生素治疗、密切观察患者情况以及在咨询放射科医生后进行CT扫描随访。巨大血肿有所缩小。

结论

对于低风险患者因会阴切开术导致的盆腔血肿,无创处理和密切监测是成功的;然而,应考虑咨询放射科医生和专家并采用多学科方法。

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